Outbreaks of gastroenteritis due to infections with Norovirus in Switzerland, 2001-2003.

Viral infections, especially those with noroviruses are the most common cause of acute gastroenteritis in Europe. To obtain information about the epidemic situation of noroviruses in Switzerland, an initial study was launched in the German-speaking part of the country to systematically compile Norovirus outbreak information between 2001 and 2003. In total, 73 outbreaks were registered. Most affected were closed settings, e.g. nursing homes (34%) and hospitals (25%). Transmission pathways were identified in 74% of Norovirus outbreaks. In 81% of these cases person-to-person transmission was the primary route of infection and on seven occasions (13%), a foodborne transmission was the possible cause. Furthermore, Norovirus outbreak characteristics of epidemiological importance are highlighted with a discussion of four selected events.

Norwalk-like virus sequences detected by reverse transcription-polymerase chain reaction in mineral waters imported into or bottled in Switzerland.

Norwalk-like viruses (NLVs) is a genus belonging to the Caliciviridae. NLVs are transmitted by the fecal-oral and the aerosol route and are the most common cause of outbreaks of nonbacterial gastroenteritis. NLVs are responsible for an estimated 67% of all illnesses caused by known foodborne pathogens and for 96% of nonbacterial gastroenteritis in the United States. Many outbreaks could be associated with the consumption of primarily or secondarily contaminated foods. To our knowledge, no epidemic arising from contaminated mineral water has been reported. We investigated the presence of NLV sequences in 63 mineral waters of 29 different brands that were imported into or bottled in Switzerland. NLV sequences were detected in 21 mineral waters by reverse transcription-seminested polymerase chain reaction. Specimens of two NLV genogroups (gg), gg I and gg II, were randomly present in the contaminated samples. The presence of NLV sequences could not be correlated either with bottle characteristics or with chemical properties like mineralization, pH, or the presence of carbonic acid. Nucleotide sequence analysis of 12 NLV-positive samples revealed several point mutations. All isolated NLV gg I strains have a similarity of 70 to 87% with the common Desert Shield virus (UO4469), and all isolated NLV gg II strains have a similarity of 89 to 93% with the Camberwell virus (U46500). Possible reasons for the presence of NLV sequences in mineral waters are discussed.

Outbreaks of foodborne viral gastroenteritis in England and Wales: 1992 to 1994.

Outbreaks of foodborne viral gastroenteritis in England and Wales from 1992 to 1994 have been analysed using data from the national surveillance scheme for general outbreaks of infectious intestinal disease. The cause was virologically confirmed for 389 (31%) of the 1280 outbreaks for which a minimum set of data were collected. Forty-seven of the 389 were attributed to foodborne transmission, 41 of which were caused by small round structured viruses (SRSV). An infected food handler was suspected to be a contributing factor in 14 and the consumption of oysters in eight of these 41 foodborne SRSV outbreaks. No seasonal pattern emerged. The highest incidences occurred in Wales, West Midlands, and South Western regional health authorities. The annual rate of outbreaks did not increase during the three year period (Chi square for linear trend 0.6; p = 0.4). Much remains to be discovered about the epidemiology of foodborne viruses, and outbreaks present an opportunity to enhance our knowledge. As molecular diagnostic techniques become routinely available, it is likely that the role of viruses in foodborne outbreaks will be increasingly recognised.

Prevalence of human papillomavirus among STD clinic attenders in Jamaica: association of younger age and increased sexual activity.

BACKGROUND AND OBJECTIVES: Human papillomavirus is the major etiologic agent of cervical cancer. Although the incidence of cancer of the cervix is high in Jamaica, the prevalence of human papillomavirus among Jamaican women has not been defined. GOAL OF THE STUDY: To estimate the prevalence of human papillomavirus infection and associated risk factors in women attending an STD clinic in Kingston, Jamaica. STUDY DESIGN: A cross-sectional survey was done of 202 women attending an STD clinic in Kingston in 1990. Cervical and vaginal cells were collected by lavage, and human papillomavirus genomes were detected in extracted DNA using low-stringency Southern blot hybridization. RESULTS: Fifty-eight (28.7%) women were identified as HPV positive. Prevalence of HPV by age group was 39% in women 15-19 years old, 33% of women 20-24 years old, 31% in women 25-29 years old, and 17% in those 30 years or older. Increasing age was significantly associated with a lower prevalence of human papillomavirus infection (test for trend, P = 0.025). The effect of age was independent of years of sexual activity. Women reporting more than one sexual partner per month on average were found to have a significantly higher HPV prevalence (odds ratio 2.87, 95% confidence Interval 1.29-6.38), as were women who reported more frequent sex (test for trend, P = 0.006). CONCLUSIONS: Sexual behavior is associated with risk of human papillomavirus infection. The decrease of human papillomavirus prevalence in older women agrees with other studies that argue in favor of a biological effect, such as increased immunity to human papillomavirus with age. A better understanding of why immunity to human papillomavirus may develop in older women may provide the basis for developing an effective vaccine to prevent cancer of the cervix.

PIP: During November 1990-January 1991, DNA was extracted from cervicovaginal cells from 202 women attending the Comprehensive Health Centre, a sexually transmitted disease (STD) clinic, in Kingston, Jamaica, to determine the prevalence of human papilloma virus (HPV). Health workers interviewed these women so researchers could identify risk factors for HPV. 58 women (28.7%) tested positive for HPV. 62% had uncharacterized HPV DNA types. 16% had more than one type of HPV. HPV prevalence fell with age (39% for 15-19 year olds, 33% for 20-24 year olds, 31% for 25-29 year olds and 17% for 30+ year olds; odds ratio [OR] for oldest group = 0.34; p = 0.025), suggesting that older women have developed an immunity to HPV infection. The higher the number of years of sexual activity, the lower the HPV prevalence (40% for 1-4 years, 32% for 5-9 years, and 23% for 10+ years; OR for 10+ years was 0.44; p = 0.03). Women with at least two sexual partners over the last 12 months had a higher HPV prevalence than those with fewer sexual partners (OR = 2.87; p = 0.01). The greater the average number of times women claimed to have had vaginal intercourse per month in the last year, the greater the HPV prevalence (OR for 3-4 times = 2.07, OR for 5+ times = 3.22; p = 0.006). A multiple logistic regression analysis revealed that age confounded the inverse association between HPV prevalence and years of sexual activity. 3% of Pap smears exhibited cervical dysplasia. Further studies are needed to obtain a better understanding of why immunity to HPV may occur in older women. This information could form the basis for developing an effective vaccine against cervical cancer.

High prevalence of HPV in a population with a high incidence of cancer in the cervix - abstract

The prevalence of human papilloma virus (HPV) was investigated in 202 Jamaican women attending a health clinic for sexually transmitted diseases in 1990. Cervicovaginal cells were collected by lavage, and HPV genomes were detected in extracted DNA using low-stringency Southern Blot hybridization. Fifty-eight (28.7 percent) women were identified as HPV-positive. Prevalence of HPV by age group was 39 percent in women aged 15-19 years, 33 percent in women 20-24 years, 31 percent in women 25-29 years and 17 percent in those aged 30 years or over. Increasing age was significantly associated with a lower prevalence of HPV infection (test for trend p = 0.025). The effect of age was independent of years of sexual activity. Women reporting more than one sexual partner per month on average were found to have a significantly higher HPV prevalence (Odds Ratio 2.75, 95 percent Confidence interval 1.24 - 6.12) as were women who reported more frequent sex (test for trend p=0.006). Sexual behaviour is clearly associated with risk of HPV infection. Moreover, the decrease of HPV prevalence in older women is in agreement with other studies that argue in favour of a biological effect such as increased immunity with age. This study is important in identifying high-risk women in Jamaica, where the incidence of cervical cancer is high (AU)

Identification of a 70 kD protein with sequence homology to squid neurofilament protein in glial cells of the leech CNS.

A monoclonal antibody G39, generated against a protein extract of leech central nervous system, labels specific cell types in adult, embryonic, and regenerating preparations. The antibody stained glial cells, microglial cells, and connective tissue cells, but not neurons or muscle on cryosections. The staining pattern resembled that of an intracellular network. Affinity purification of the antigen revealed a 70 kD protein. Peptide sequencing showed significant homology of a stretch of 15 amino acids to squid neural filament protein. The same mAb G39 delineated glial cells as they formed during development of the CNS and showed that the giant neuropil glial cells appear before those in the packets. The antigen recognized by mAb G39 represents a nonneuronal intermediate filament of the leech Hirudo medicinalis found in various cell-types such as glia, microglia, and some cells of the connective tissue.

Molecules that become redistributed during regeneration of the leech central nervous system.

A search has been made for molecules other than laminin that change their distribution during axonal regrowth after injury. Two monoclonal antibodies, generated against a protein extract of leech central nervous system (CNS), stain distinct regions of leech CNS and, following lesions, show changes in distribution with time. 1. Monoclonal antibody NP17 stained two bands of M(r) 80 x 10(3) and 60 x 10(3) on Western blots of protein extracted from whole CNS. On cryosections of leech CNS, staining was predominantly within the neuropile. 2. A second antibody, mAb CT16, stained a collagen-associated molecule of the extracellular matrix. It labelled the outer capsule, which surrounds the neuronal cell packets, and the inner capsule, which envelopes the neuropile. In the connectives, CT16 immunoreactivity was restricted to the connective capsule and was not associated with nerve fibres or glia. 3. When the connectives were crushed, immunocytochemical studies revealed changes in distribution of both mAb NP17 and mAb CT16. After 3 days, a time when fibres begin to sprout and form connections, an increase in NP17 immunoreactivity appeared at the site of the lesion. Staining levels remained elevated for several weeks. In contrast, CT16 immunoreactivity did not change for several days after damage. After 10 days, fibre-like staining appeared at the site of the crush; for several weeks it continued to spread throughout the connective. 4. These results show that regeneration of the leech CNS involves the redistribution of at least two molecules. Using monoclonal antibodies, these two molecules, which are situated in distinct regions of the CNS, have been visualized at different stages of the repair process. It has been shown that they alter their distribution at distinct times during regeneration.

Synapsins contain O-linked N-acetylglucosamine.

The neuron-specific synaptic vesicle-associated phosphoproteins synapsin I and synapsin II were shown to contain terminal N-acetylglucosamine (GlcNAc) residues as determined by specific labeling with bovine galactosyltransferase and UDP-[3H]galactose. The beta-elimination of galactosyltransferase radiolabeled synapsin I and subsequent analysis of released saccharide on high-voltage paper electrophoresis confirmed the presence of monosaccharidic GlcNAc moieties in O-linkage to the protein. Partial cleavage of synapsin I by collagenase, 2-nitro-5-thiocyanobenzoic acid, and Staphylococcus aureus V8 protease suggests that at least three glycosylation sites exist along the molecule. Taken together these data present the first evidence that a neuron-specific protein contains O-glycosidically bound GlcNAc.